ABSTRACT
IntroductionAs of 3rd June 2021, Malaysia is experiencing a resurgence of COVID-19 cases. In response, the federal government has implemented various non-pharmaceutical interventions (NPIs) under a series of Movement Control Orders and, more recently, a vaccination campaign to regain epidemic control. In this study, we assessed the potential for the vaccination campaign to control the epidemic in Malaysia and four high-burden regions of interest, under various public health response scenarios. MethodsA modified susceptible-exposed-infectious-recovered compartmental model was developed that included two sequential incubation and infectious periods, with stratification by clinical state. The model was further stratified by age and incorporated population mobility to capture NPIs and micro-distancing (behaviour changes not captured through population mobility). Emerging variants of concern (VoC) were included as an additional strain competing with the existing wild-type strain. Several scenarios that included different vaccination strategies (i.e. vaccines that reduce disease severity and/or prevent infection, vaccination coverage) and mobility restrictions were implemented. ResultsThe national model and the regional models all fit well to notification data but underestimated ICU occupancy and deaths in recent weeks, which may be attributable to increased severity of VoC or saturation of case detection. However, the true case detection proportion showed wide credible intervals, highlighting incomplete understanding of the true epidemic size. The scenario projections suggested that under current vaccination rates complete relaxation of all NPIs would trigger a major epidemic. The results emphasise the importance of micro-distancing, maintaining mobility restrictions during vaccination roll-out and accelerating the pace of vaccination for future control. Malaysia is particularly susceptible to a major COVID-19 resurgence resulting from its limited population immunity due to the countrys historical success in maintaining control throughout much of 2020.
ABSTRACT
This study aims to examine selected factors of dementia patients and their caregivers that were associated with the burden of family caregivers. This cross sectional study involves face-to-face interview with family caregivers of patients with dementia. Participants were recruited through convenient sampling from geriatric and psychiatry outpatient clinics from three government hospitals, one university hospital, one rural health centre and Alzheimer Disease caregivers' support groups. 70 caregivers took part in the study. Measures included patient and caregiver demographic variables and caregiver burden using the Zarit Burden Interview (ZBI). Caregiver burden was found to be significantly associated with both ethnicity and informal support. Chinese caregivers were found to have a higher level of burden compared to Indians and Malays. Informal support, in particular assistance from family members, was significantly associated with a lower burden perceived by the caregivers. However, the study shows that formal support such as assistance from maids and private nurses did not alleviate the burden of caregivers. Results highlighted the importance of improving the coping skills in burdened caregivers particularly among family members with dementia relatives. Interventions should be designed for specific needs of caregivers of different ethnicities.
